Radiation-induced Primary Pulmonary Angiosarcoma After Treatment for Breast Cancer

Background. There are few reports of primary pulmonary angiosarcoma. We herein report a case of primary pulmonary angiosarcoma developing in the left upper lobe, which was involved in the radiation range of adjuvant therapy for breast cancer after surgery. Case. The patient was a 47-year-old woman, who had previously undergone partial resection for multiple breast cancer. She had received adjuvant chemoradiotherapy and continued to receive hormone therapy. An abnormality was detected on a chest radiograph obtained in a periodic health examination 8 years after surgery. Recurrence of breast cancer, primary lung cancer, and inflammatory change were considered in the differential diagnosis. A bronchoscopic examination and pleural fluid cytology did not provide us with malignant findings; thus, we decided to perform exploratory surgery. The intraoperative findings indicated a nodular lesion in the lingular segment, bloody effusion, and multiple lesions in the parietal pleura. We performed partial resection of the lung lesion and pleural biopsy, which were diagnosed as primary pulmonary angiosarcoma and pleural dissemination. Contrast CT performed 1 month after the operation revealed the progression of pleural dissemination and multiple lymph node and liver metastases. Chemotherapy was administered; however, the patient eventually died 6 months after the operation. Conclusion. We described a rare case of primary pulmonary angiosarcoma. In this case, we concluded that this angiosarcoma could be a radiation-induced sarcoma because it developed in the radiation range of radiotherapy administered after breast cancer surgery.